Comparing the Catastrophic Health Expenditures on Different Non-Communicable Diseases Among Households in Goa, India

Abstract

The prevalence of NCDs is high in Goa. Households bear a significant burden of medical costs in India. The increased out-of-pocket expenditures on health can, in some cases, drive households into poverty, leading them to incur catastrophic health expenditures. Based on the statistics of Goa for 2016, the leading causes of disability-adjusted life years (DALYs) among the non-communicable diseases (NCDs) were ischaemic heart disease (11.0%), diabetes (4.1%), followed by chronic obstructive pulmonary disease (4.1%), stroke (4%) and chronic kidney disease, which accounted for 2.3% of the DALYs. Owing to the increasing burden of NCDs in the state of Goa, this article uses a sample of 309 NCD patients to analyse the expenses incurred on three NCDs, namely, diabetes, cancer and cardiovascular illness in terms of costs incurred on medicines, laboratory test costs and hospital stays using Ordinary Least Squares (OLS). The article also compares the indirect costs, that is, loss of earnings as a result of man-days lost for both the patient and the caregiver. The article studies the relationship between socio-economic groups and the impact of an NCD. Finally, the study uses a Bayesian model to compare the likelihood of the household incurring catastrophic health expenditures if afflicted with an NCD. The results indicate an alarming trend in the impoverishment of households due to expenditures on NCDs. Given the chronic nature of NCDs and an increasing rate of prevalence, the government must focus on expanding its public healthcare system and financing for households nearing poverty. Subsequently, they must also focus on awareness campaigns that can promote healthier lifestyles that can play a role in preventing the onset of such NCDs.